Enclosed versus open nursing stations in adult acute care psychiatric settings: does the design affect the therapeutic milieu?

Specific efforts by hospital accreditation organizations encourage renovation of nursing stations, so nurses can better see, attend, and care for their patients. The purpose of this study was to examine the effect of nursing station design on the therapeutic milieu in an adult acute care psychiatric unit. A repeated cross-sectional, pretest-posttest design was used. Data were collected from a convenience sample of 81 patients and 25 nursing staff members who completed the Ward Atmosphere Scale. Pretest data were collected when the unit had an enclosed nursing station, and posttest data were collected after renovations to the unit created an open nursing station. No statistically significant differences were found in patient or staff perceptions of the therapeutic milieu. No increase in aggression toward staff was found, given patients' ease of access to the nursing station. More research is needed about the impact of unit design in acute care psychiatric settings.     

Approaches used by employee assistance programs to address perpetration of intimate partner violence

Employee Assistance Programs (EAPs) are workplace resources available to employees with problems impacting work performance. EAPs are well-positioned to address intimate partner violence (IPV), a major public health problem with workplace impacts. A purposeful sample of 28 EAPs across the United States was surveyed to identify policies and programs to address IPV, including perpetration. Most EAPs did not report having standardized approaches for addressing IPV perpetration. EAPs also described significant barriers to identifying IPV perpetrators, with the majority relying on self-disclosure on the part of the perpetrator when contacting the EAP. These results suggest that many EAPs--even when interacting with employees who present with issues known to correlate with IPV--are missing a potential opportunity to assess and intervene with IPV perpetrators.     

Older adults' narratives about a flood disaster: Resilience, coherence, and personal identity

Older adults are a vulnerable group in a disaster and are more at risk of adverse effects as a result. This paper draws on the use of narrative theory in health and gerontology studies to examine how a disruptive disaster was storied. Narrative interviews were conducted with nine older adults aged over 65 years who had recently experienced a flood disaster. The participants' narratives about the disruptive event were integrated with past personal events that spanned more than seven decades. The disaster became a reference point for previous challenging experiences, which created biographical continuity, coherence and order over time. Furthermore, the disaster stories were about biography and identity, and showed how older adults made sense of the flood from a life-course perspective. The use of narrative approaches provides an insight into how the flood disaster was experienced, and reveals how four older adults storied their experiences of a significant life challenge.     

Specialisation and training for fire-fighters driving heavy rescue vehicles: consequences for the development of operators?

This work was undertaken in France at the request of a local fire and rescue school in order to conduct an analysis of driving two types of heavy rescue vehicle with a view to improving training. This study took place in a context of specialisation: the drivers of these vehicles will henceforth only perform this type of task. Consequently, specific training has been designed in advance. Our study concerns the improvement of this training, taking account of the particularities of driving these vehicles in emergency situations typical to the profession of fire-fighters. The results stress first that driving of rescue vehicles in emergency situations is a multidimensional collective activity. Driving strategies identified share certain common objectives: "optimising trajectories", warn other road users, anticipate their behaviour and leave room for manoeuvre to counter and react to any unexpected behaviour. They include risks management for the potential victims of the incident and the risk of accidents during the journey. These initial results help identify certain recommendations for the training courses dealing with driving vehicles in emergency situations. They also provide a warning concerning the possible consequences of driver specialisation.     

Can the New Deal solve the old problem of aid orphans and darlings? Aid effectiveness in fragile states

The New Deal for Engagement in Fragile States marks an important ideological shift in development co‐operation. Despite this progress, no practical response has been found to the problem of aid co‐ordination. This article traces the issue of aid allocation and highlights lessons from the ‘aid orphan’ and ‘aid darling’ debate. It examines the significant, yet under‐reported, policy process of the New Deal. It argues that deeper engagement with the concept of trust, and renewed focus on the political elements of the agreement, should be key priorities for the International Dialogue on Peacebuilding and Statebuilding.     

Victimization, Care and Justice: Reflections on the Experiences of Victims/Survivors Involved in Large-scale Historical Investigations of Child Sexual Abuse in Residential Institutions

Correspondence to Professor Matthew Colton, Centre for Applied Social Studies, School for Social Science and International Development, University of Wales Swansea, Science Tower, Singleton Park, Swansea SA2 8PP, UK. Summary Large-scale investigations into historical child abuse in residentialinstitutions have been undertaken throughout the United Kingdom.This paper reflects on the experiences of those who give evidencein such investigations, drawing on interviews carried out withtwenty-four victims/survivors. Emerging themes include: thefactors which motivate victims/survivors to make disclosures;the impact on individuals of involvement in an investigation;the nature and effectiveness of help and support offered tovictims/survivors; the level of priority given to the needsof victims/survivors; and issues concerned with power and gender.The concluding discussion highlights vital issues for socialworkers and social services departments.     

Negotiating deficiency: Exploring ethnic minority parents' narratives about encountering child welfare services in Norway

Evaluating the participatory opportunities for service users within social welfare institutions is a pressing issue. In this article, we explore a group of ethnic minority parents' experiences with child welfare services (CWS) in Norway. A strong narrative theme was deficiency positioning—how lacking a Norwegian normative set of knowledge and skills challenged the parents' opportunities to participate. We analysed how deficiency positioning was perceived, negotiated, and contested in the parents' accounts, and 4 themes emerged: (a) learning to parent, (b) contesting expert knowledge, (c) learning to be a client, and (d) constructing CWS deficiency. Nancy Fraser's concept of “participatory parity” was applied to explore how current institutional structures may enable and limit parents' participation. The analysis provides insight into agencies and informants' sense‐making processes as well as the diverse resources and strategies that parents draw upon in the CWS encounter. Furthermore, we argue that an interplay between a strong focus on “parenting skills” and bureaucratic and economic structures positions ethnic minority parents as deficient, thus providing powerful mechanisms for marginalization. Implications for case work and institutional levels are discussed.     

Communicating Contaminant Risks from Sport-Caught Fish: The Importance of Target Audience Assessment

A fish consumption health advisory has existed for New York Lake Ontario sport-caught fish since 1978. Our study objectives were to evaluate the effectiveness of the advisory for reaching potential target audiences and to identify appropriate advisory content, style, and dissemination methods using a risk communication planning model as an evaluation framework. We used a combination of mail surveys and personal interviews with three target audiences (opinion leaders among recreational anglers and charter boat operators, migrant farm workers, and low-income individuals) and two communicator groups (fishery experts and health care experts). The New York Lake Ontario advisory appeared to be successful in reaching and encouraging risk-mitigating fish consumption behavior in recreational angler opinion leaders and low-income individuals but not in migrant farm workers. The advisory may not be reaching two sensitive subpopulations, women of childbearing age and children. Communicators and target audiences differed in their assessments of important information to include in an advisory. The health advisory could be improved with additional information such as risk-reducing cooking and cleaning methods and by diversifying the dissemination methods to reach the variety of audiences who potentially consume Lake Ontario fish.     

Outcome study: An industrial rehabilitation program

A review of work hardening outcome research reveals a wide range of return to work statistics between 50% to 80%. Managed care issues are forcing therapy services to objectively quantify their successes to ensure a future in health care. Work Venture has been maintaining program outcome statistics since 1994. In this report, 1997 and 1998 return to work statistics are documented and compared to multiple programs. Work Venture's average annual return to gainful employment percentages for 1997 are 61.2% at 3 months and 61.8% at 6 months, and in 1998, 76.8% at 3 maonths and 76.6% at 6 months after discharge. Many factors are involved in successful return to work with workers compensation claims. Due to these factors it is difficult to compare one program's results with another. It is recommended that a uniform method of collecting and presenting data be developed to ensure valid comparison.